tbuckley/cabot-search huggingface dataset:
AB1189 THE RISK OF FLARE UP FOLLOWING nSARS-CoV2 VACCINE IN INFLAMMATORY ARTHRITIS
Authors: F. Frizzera, F. Pettorossi, P. De Sandre, G. Scanelli, A. Hoxha
Journal: Annals of the Rheumatic Diseases (2022)

Background As autoimmune phenomena following anti-nSARS-CoV2 vaccine was reported in the healthy population, there is increasing concern in patients with inflammatory joint diseases regarding possible side effects and disease flare-ups. Objectives We set out to evaluate the possible risk of disease exacerbation and the predisposing risk factors for the flare up. Methods This is a single center prospective cohort study, enrolling patients attending Arthritis Clinic at San Bortolo Hospital, during a follow-up of 12 months. All patients, after obtaining informed consent, answered a 24-item questionnaire including information about nSARS-CoV2 infection, vaccination, disease activity, ongoing treatment, vaccine side effects, disease flare up and need to change therapy. Results A total of 109 patients, 60 (55.1%) females and 49 (44.9%) males with a mean age of 60.1 years ±12.6 SD were enrolled. Forty-three (39.5%) were affected by rheumatoid arthritis, 43 (39.5%) from psoriatic arthritis and 23 from anchylosing spondylitis. There were 19 (17.43%) nSARS-CoV2 infection, of them 3 (15.8%) need hospitalization. Ninety-five (87.2%) receive at least one shot of nSARS-CoV2 vaccine, of these 78 (82.1%) got three shots of vaccine. Vaccine-related side effects were reported in 36 (37.9%), of these 15 (41.7%) have fever, 14 (38.8%) arthralgia and 29 (80.5%) fatigue. No patients required medical attention. Twenty (21.05%) of patients who receive at least one vaccine shot experienced a flare up. Nine (45%) need to change therapy. The risk of flare up was significantly associated with low disease activity/active disease in the last 12 months, p=0.009; OD 4.0; 95% CI: 1.5-11.3. Conclusion Overall, the nSARS-CoV2 vaccine is well tolerated in patients with inflammatory arthritis. The risk of disease flare is associated with active disease within the past 12 months. According to our results, the patients affected by inflammatory arthritis in sustained remission have no reason to hesitate to get the nSARS-CoV2 vaccination. Disclosure of Interests None declared
AB1445 SYNOVIAL FLUID ANALYSIS IN HOT SWOLLEN JOINTS – A QUALITY IMPROVEMENT PROJECT
Authors: F. Rabbani, Z. Jaffer, L. Sammut
Journal: Annals of the Rheumatic Diseases (2022)

Background Previous studies have reported delays in the investigation and suboptimal management of hot swollen joints, particularly crystal arthritis. In our hospital, it was noted that synovial fluid was inconsistently analysed for crystals which may lead to patients receiving delayed treatment. Objectives The aim of this quality improvement project was to 1) identify the number of synovial fluid samples that were not checked for crystals 2) implement changes to improve this process 3) re-audit and commitment to a continuous evaluation. Methods Retrospective review of synovial fluid analysis requested for adult patients presenting with hot swollen joints over a six month period. Following, the implementation of changes in the hospital, another comparison of pre-post intervention was performed. Results A total of 106 synovial fluid samples were sent for analysis between March and August 2021, of which only 69 (65%) of the samples were analysed for crystals. All samples were analysed for microscopy and culture. Following involvement with IT and laboratory departments we have introduced an intervention to make requesting crystal analysis easier. The request for synovial fluid analysis was grouped in a bundle (reflex test) so whenever a synovial fluid is collected, two forms are generated, one for microbiology (microscopy and culture), and the other for cytology (crystal analysis). Additional interventions included education and raising awareness. Post-interventions, another three month analysis of synovial fluid showed that compliance improved to 78%. Conclusion There was an improvement in the synovial fluid analysis requests of patients with hot, swollen joints. By implementing these changes and raising awareness, patients with acute crystal arthritis can be treated in a timely manner. We plan to continue our work with synovial fluid analysis following re-review and will continue to generate improvements. Disclosure of Interests None declared
AB0403 EVALUATION OF THE SAFETY AND EFFICACY OF 13-VALENT PNEUMOCOCCAL VACCINE IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: G. Lukina, D. Murtazalieva, E. Koltsova, M. Kostinov, A. Shmitko, D. Blagovidov, E. Zhilyaev
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is accompanied by a significant increase in the risk of infection and serious infections, among which pneumonia occupies a leading place. (1) The use of targeted anti-inflammatory drugs is accompanied by an additional increase in the risk of infectious complications. In this regard, vaccination is crucial in the management of such patients. Objectives To evaluate the safety and efficacy of the 13-valent pneumococcal vaccine in patients with RA undergoing various types of antirheumatic therapy. Methods The study included 60 patients with a reliable diagnosis of RA, according to the criteria of ACR/EULAR, among them 8 men and 52 women, average age 63 years (from 29 to 69 years) with disease activity at the time of inclusion of Das-28 – 4.9 (2.2-7.7), bionaive patients with insufficient response to DMARDs who will be prescribed tofacitinib (TOFA) for the first time or receiving TOFA for at least 3 months (30 patients in each group). Both groups of patients were further subdivided into two groups, 15 vaccinated and unvaccinated patients in each. The exclusion criteria were: age over 70 years; patients with infectious diseases in the acute stage; having a history of intolerance to diphtheria toxoid, patients who had previously been vaccinated with pneumococcal vaccines. For the prevention of pneumococcal infection, a pneumococcal 13-valent polysaccharide conjugated adsorbed vaccine was used. Visits to assess the condition were made in the period of 0-3-12 months. The activity of the disease was assessed by the DAS 28, CDAI, SDAI indices. Results Among vaccinated patients with PCV 13 the most common adverse events were: pain at the injection site (16%), fever up to 37.6C (13%), redness at the injection site (6%), infiltration at the injection site (2%), myalgia (2%). These adverse events resolved spontaneously within 3 days. In a comparative assessment of infectious events during 12 months before vaccination and the next 12 months after it, there were no significant differences between vaccinated and unvaccinated patients. In patients who had a history of pneumococcal etiology infections after vaccination, the incidence decreased by 33%. Conclusion Vaccination against pneumococcal infection is a safe and effective method of preventing pneumococcal infection in patients with rheumatoid arthritis. References [1]Koivuniemi R., Leirisalo-Repo M., Suomalainen R., etc. Infectious causes of death in patients with rheumatoid arthritis: an autopsy study. Scand J Rheumatol 2006; 35)4): 273-6 Disclosure of Interests Galina Lukina Speakers bureau: Ebbvie, Biocad, Pfizer, Roche, Dzhamilya Murtazalieva: None declared, Ekaterina Koltsova: None declared, Mikhail Kostinov: None declared, Anna Shmitko: None declared, Dmitry Blagovidov: None declared, Evgeniy Zhilyaev Speakers bureau: Ebbvie, Biocad, Pfizer, Roche
Endoscopy International Open – recently published
Journal: Endoscopy (2022)

Comment on: Safety and effectiveness of underwater cold snare resection without submucosal injection of large non-pedunculated colorectal lesionsEndosc Int Open 2022; 10(06): E791-E800DOI: 10.1055/a-1784-4523 Comment on: Quality measures in endoscopy: A systematic analysis of the overall scientific level of evidence and conflicts of interestEndosc Int Open 2022; 10(06): E776-E786DOI: 10.1055/a-1809-4219 Comment on: Natural history of gastrointestinal schwannomasEndosc Int Open 2022; 10(06): E801-E808DOI: 10.1055/a-1784-0806
AB0223 COXITIS AND ATLANTOAXIAL SUBLUXATION IN RHEUMATOID ARTHRITIS: IS THERE A LINK?
Authors: A. Ben Tekaya, S. Rezgui, O. Saidane, R. Leila, S. Bouden, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease that can over time be debilitating and life threatening vital prognosis through Atlantoaxial subluxation(ASS) and functional prognosis through coxitis. Objectives The aim of this work was to determine the correlation between coxitis and AAS in RA. Methods We performed a cross-sectional comparative study including 182 patients with RA meeting the ACR-EULAR 2010 criteria in a rheumatology department during the period from 2000 to 2021. The socio-demographic, clinical and radiological features were collected. Results Among the 182 patient enrolled, 16.4% (n=30) of patients had coxitis: unilateral in (90.24%; n = 27) and bilateral in (9.76%; n = 3). The coxitis was significantly found in males with a percentage of 40% vs 13.5% in females (p=0.01). As it for the AAS, it was noted in 13.3% of our patients more frequently in males 41.2% vs 17.8% in females (p=0.044). The discovery of AAS on standard radiographs was fortuitous in 70.4% of cases (systematic radiographic assessment for structural assessment of RA) and in 29.6% of cases presenting an inflammatory neck pain. Cervical MRI was pathological in 63.4%. The abnormalities observed on MRI were: C1 – C2 synovitis (47.6%), confirmed LAA (42.9%) and basilar impression (9.5%). C1-C2 instability was presumed anterior (90.9%), lateral (6.1%) and rotatory (3%). Two patients had basilar impression. The occurrence of an atlantoaxial subluxation was significantly correlated to the anterior presence of a coxitis (p=0.000). Conclusion Our study suggest that in RA, the presence of a coxitis;mostly in males; can be a predictive factor for the occurrence of AAS but further studies are needed to confirm these results. Disclosure of Interests None declared
Intra-arterial Alteplase vs Placebo After Successful Thrombectomy and Functional Outcomes in Patients With Large Vessel Occlusion Acute Ischemic Stroke
Authors: Hui Mai, Tao Chen, Fengjian Chen
Journal: JAMA (2022)

To the Editor We have some concerns about the recent CHOICE study1 that compared intra-arterial alteplase with placebo among patients with large vessel occlusion acute ischemic stroke after successful thrombectomy.
Concerns Regarding Robotic vs Laparoscopic Right and Extended Right Hepatectomy—Reply
Authors: Charing C. Chong, Joseph J. Zhao, Brian K. P. Goh
Journal: JAMA Surgery (2022)

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AB0083 RELATIONSHIP BETWEEN APOLIPOPROTEIN C-III AND ACTIVATED FACTOR VII-ANTITHROMBIN COMPLEXES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PSORIATIC ARTHRITIS
Authors: A. Zielińska, E. Zielinska, J. Wroński, J. Natorska, A. Paradowska-Gorycka, P. Głuszko
Journal: Annals of the Rheumatic Diseases (2022)

Background Both rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are associated with increased cardiovascular risk and thrombosis. Alterations in plasma lipids levels, including apolipoproteins are recognized as the important risk factors of cardiovascular disorders. Activated Factor VII -anti- Thrombin complex (FVIIa-AT) is a marker of the extrinsic coagulation cascade activation, the pathway accelerated by interaction with plasma apolipoprotein C-III (Apo-CIII) (1). Objectives To investigate the associations between plasma FVIIa-AT concentration, lipid profile including apolipoprotein CIII, and markers of disease activity in patients with RA and PsA. Methods 41 patients with RA, 38 with PsA, and 22 healthy controls, all not taking anticoagulant drugs were selected for the study. The lipid profile comprised triglycerides (TG), total cholesterol (TCh), low (LDL), and high-density lipoprotein (HDL). Serum levels of Apo C-III were measured using a Human ApoCIII ELISA kit CellBiolabs Inc.Austria. FVIIa–AT plasma concentrations were determined using ELISA test. C-reactive protein (CRP) level was measured using the immunoturbidimetric assay. All measurements were performed by a technician blinded to sample origin. The Mann-Whitney test and Kruskal Wallis tests were applied for intergroup comparisons, and correlations were assessed using Spearman’s rank tests, due to data non-normal distribution. Results The highest serum levels of Apo C-III were found in RA patients (median: 99.9μg/ml, min.-max. 8.7–199) compared to PsA (30.86μg/ml, 12.4–125.8) and controls (9.5 μg/ml, 3.7–29.2), p&lt;0.001. RA and PsA patients revealed higher FVIIa-AT plasma levels than controls (RA median 153.8 pM, min.—max. 57.0–397.8, PsA 157.6 pM, 64.9– 323.8 vs controls 104.5 pM, 68.9–150.9, p&lt;0.001). In RA and PsA patients ApoCIII correlated positively with TG levels (r=0.35, p=0.027 and r=0.38, p=0.018 respectively). In all patients and controls, Apo C-III levels correlated positively with FVIIa-AT concentrations (r=0.45 p&lt;0.001). No significant differences were found in the serum concentrations of TCh, LDL, HDL, TG, and CRP, between the groups of RA and PsA patients. Conclusion Elevated concentrations of both, apolipoprotein CIII and activated FVII-AT complexes in rheumatic patients suggest associations between plasma lipoproteins and activation of coagulation cascade leading to a pro-thrombotic state in patients with RA and PsA. Further studies on these relationships are necessary taking into account various clinical conditions of patients and treatment. References [1]Martinelli N et al. Apolipoprotein C-III Strongly Correlates with Activated Factor VII-Anti-Thrombin Complex: An Additional Link between Plasma Lipids and Coagulation. Thromb Haemost. 2019; 119: 192-202. Disclosure of Interests None declared
Errors in Text, Table, and Figure
Authors: Mabel Chung, Susan Smith
Journal: JAMA Cardiology (2022)

Mabel Chung, MD, MPH; Kamil F. Faridi, MD, MSc; Dhruv S. Kazi, MD, MSc, MS; Zaid I. Almarzooq, MD; Yang Song, MS; Suzanne J. Baron, MD, MSc; Robert W. Yeh, MD, MSc, MBA
AB1578-PARE A PATIENT-REPORTED OUTCOME SCALE: RASQ FOR MEASURING SYMPTOMS OF RHEUMATOID ARTHRITIS
Authors: S. Rekik, Z. Zeineb, S. Boussaid, S. Rahmouni, S. Jemmali, K. Zouaoui, H. Sahli, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2022)

Background Patient-reported outcome (PRO) instruments are used to assess the patient experience of rheumatoid arthritis (RA) symptoms and impacts and can capture RA treatments effects. Also, there are often discrepancies between patient and physician perspectives. Objectives The objective of our study was to proceed with a psychometric evaluation of patients with RA using the Rheumatoid Arthritis Symptom Questionnaire (RASQ). Methods Adults with clinically confirmed RA, as defined by the ACR/EULAR criteria, were recruited for this cross-sectional study, and then completed the RASQ. Medical records were reviewed, clinical features, treatments, and outcomes were analyzed. Results In total 28subjects (82% females) with RA were included. The meanagewas58.5years (31-79 years). Comorbiditieswerepresentin86 %, diabetes (50%), high blood pressure (32,1%), dyslipidemia (25%), thyroid disease (3,7%), Depression (7.1%).The mean duration since RA diagnosiswas9,8 years. Almost all the patients had at least one of the disease severity criteria, high level of CRP (76%), radiographic erosion (96%), C1-C2 involvement (18%), or hip involvement (14,2%). All of the patients received CsDMARDs and biological therapy. Disease activity evaluated by the DAS28 score was in remission or very low disease activity in 38%, moderate (46%), and high (16%). Functional impact evaluated by the Health Assessment Questionnaire (HAQ)was an average of 1.1 (0.2–3). The RASQ total symptomwas6.6 (2-10). The mean of each item was joint pain (5.4), joint swelling (5.5), joint stiffness (6.1), joint tenderness (4.1), joint warmth (4.3), muscle pain (6), tiredness (5.7). The RASQ total symptom was statistically significantly different (p=0.01) across the DAS28severityrankings but only the first two single items of the RASQ were not statistically significantly different (p=0.9 and p=1,6). A medium positive correlation was found between subjects’ HAQ score and the total symptom score of the RASQ (r=0,38). Conclusion The primary goal of treating patients with RA is to maximize the long-term health-related quality of life. In this order, measurement of all of the signs and symptoms of RA that are significant and relevant to patients living with the disease is important to achieve this main objective. Disclosure of Interests None declared
AB1212 GENDER DIFFERENCES IN FIBROMYALGIA PATIENTS IN VIEW OF THE 1990, 2011, AND 2016 ACR CRITERIA
Authors: A. Moshrif, M. Z. Shoaeir, A. S. Abbas, T. M. Abdel-Aziz, W. Gouda
Journal: Annals of the Rheumatic Diseases (2022)

Background Fibromyalgia (FM) is a common rheumatic illness distinguished by chronic pain, headache, fatigue, cognitive problems, and functional disability. However, the differences between men and women have not yet been comprehensively studied, especially after the development of the last 2016 American College of Rheumatology (ACR) criteria. Objectives The aim of this study was to evaluate the gender differences in symptom characteristics, cognitive dysfunction, and disease severity in Egyptian FM patients considering both the ACR 1990, 2011, and the last 2016 ACR diagnostic criteria Methods In this cross-sectional study, 352 individuals with fibromyalgia were interviewed from January 1, 2020, to June 1, 2021. In addition to the number of tender points (TPC), data was collected on age, gender, body mass index (BMI), marital status, disease onset, duration, and diagnostic delay. The Widespread Pain Index (WPI), the Symptom Severity Scale (SSS), fatigue, cognitive dysfunction, sleep disturbance, awakening unrefreshed, headache, abdominal pain, and depression were evaluated and scored according to 2010 and 2016 ACR criteria. The questionnaire includes a visual analog scale (VAS) for pain, fatigue, stiffness, anxiety, and depression. Total score ranges were calculated with total score ranges between 0 and 80 (without job items), where higher scores indicated a greater negative impact and/or severity of symptoms. The Polysymptomatic distress scale (PDS) has been calculated by the summation of the SSS with the WPI. The Revised FM impact questionnaire (FIQR) has also been evaluated. Results The study shows that females have a significantly higher prevalence of fatigue, cognitive dysfunction, sleep disturbance, headache, and abdominal pain (p &lt; 0.05). Also, females showed significantly higher scores than males regarding WPI, SSS, and mean TPC (p = 0.004, 0.027, and 0.001, respectively). While there was no difference regarding the FIQR (p=0.93), PDS was significantly higher in women (p= 0.001). Conclusion Female patients with FM had greater disease severity scores, symptomatology, and number of tender points. Whatever the criteria applied, the prevalence and intensity of the disease features are higher in females, which may underestimate the disease in male patients. Disclosure of Interests None declared
AB0857 Increased carotid intima-media thickness is correlated with renal function in spondyloarthritis
Authors: A. Ben Tekaya, T. Mehmli, S. Boukriba, F. Ahmed, O. Saidane, R. Leila, S. Bouden, R. Tekaya, I. Mahmoud, H. Mizouni, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Cardiovascular diseases are the main cause of mortality in spondyloarthritis and seem to be multifactorial. Due to its easy application and reproductibility, carotid intima-media thickness (CIMT) is increasingly used for assessment of subclinical atherosclerosis and cardiovascular risk stratification. Objectives The aim of our study was to investigate the relationship between CIMT and renal function in patients with spondyloarthritis (SpA). Methods We performed a cross sectional study including 47 patients with SpA and no history of cardiovascular disease. Clinical and biological data were recorded. Data related to renal involvement and creatinine level were extracted. CIMT was measured in the right and the left common carotid artery by an experienced radiologist; than mean CIMT was calculated. Results Our study included 33 men and 14 women with a sex ratio of 2.35, a median age of 36 years (IQR 25-75%: 28-46) and a median duration of the disease of 11 years (IQR 25-75%: 5-16). Renal involvement was found in 6 patients (13%): kidney stones (n=2), tubulo-interstitial nephritis (TIN) (n=2), IgA nephropathy (n=1) and AA amyloidosis (n=1). Median creatinine level was 63 μmol/l (IQR 25-75%: 58.5 - 64). No patient had kidney failure. Ultrasound examination found median right, left and mean (CIMT) of 0.54 mm (IQR 25-75%: 0.50-0.63), 0.55 mm (IQR 25-75%: 0.49-0.61) and 0.55 mm (IQR 25-75%: 0.48-0.62) respectively. Increased CIMT values were found in 8 patients (17%). No patient had atherosclerotic plaque. Patients with renal involvement had significantly higher values of CIMT (0.64 mm (IQR 25-75%: 0.56-0.70) vs 0.53 mm (IQR 25-75%: 0.47-0.59); p= 0.045). Significant positive correlation was also detected between CIMT values and creatinine level (p=0.002; r=0.445). In multivariate linear regression, creatinine level was identified as independent predictor of increased CIMT (B=0.002; 95% confidence interval=0.000-0.005; p=0.035). Conclusion Although all patients included have normal creatinine level, we identified creatinine level as independent predictor of subclinical atherosclerosis in SpA patients. This finding highlights the monitoring of this parameter. Disclosure of Interests None declared